OBSTETRICS &


GYNAECOLOGY
All about
ovarian cysts


There may often be nothing to worry about when it comes to ovarian cysts - but those that cause painful symptoms or bleeding require medical attention.


Dr Kelly Loi
Obstetrician & Gynaecologist

 

 

 

 

 

 

Cysts refer to small, fluid-filled sacs which sometimes form in the ovaries for different reasons. In many cases, ovarian cysts are a natural process of the fertility cycle, and not something to be concerned about. The ovaries, part of a woman’s reproductive system, are organs that produce all the eggs a woman needs in her lifetime. They also make female sex hormones that support fertility and hormones for mental and cardiac health.

Benign cysts

In most cases, these cysts are functional, meaning that they form as part of the menstrual cycle. Functional cysts form after the ovulation process. In a normal ovulation cycle, several small follicles grow in the ovaries. Typically, one of these follicles will grow to become the dominant one and release a mature egg du ring ovulation. The other follicles will then shrink. But when a follicle does not dissolve or when an egg fails to detach, a cyst is formed.

Another type of functional cyst is called a corpus Iuteum cyst. This is formed after ovulation, when a cyst forms from the remains of the follicle after the egg has moved into the fallopian tubes (called the corpus luteum). These functional ovarian cysts are actually very common and occur at all ages, and are most frequently found in wome n of child-bearing age, typically from age 20 to 40.

Other types of cysts

Non-functional cysts are usually more of a concern. Apart from the risks of cancer, these cysts can often cause pain and affect fer tility. One type of non - functional cyst is when tissue

from the lining of the uterus grows in other areas of the body such as the ovaries. This cond ition is called endometriosis and causes abnormal menstruation and pain. Another type is called cystadenomas, which are fluid-filled cysts formed from the cells on the surface of the ovary. Dermoid cysts form during foetal development when an abnormal array of cells becomes trapped in the ovary, giving rise to tissue similar to that of hair, skin or teeth. Polycystic ovaries, on the other hand, refer to ovaries with a mass of multiple follicles that do not go away on their own and are associated with hormonal complications and failure to ovulate.

Early detection

While most ovarian cysts are harmless, some can cause problems if they bleed, rupture or become infected. Medical help is important for non-functional cysts as they can cause severe pain and infertility. Importantly, it is good to be aware of any changes in your menstrual cycle as the symptoms for ovarian

cysts and ovarian cancer are similar. You should ask your fertility doctor about doing a routine pelvic examination or an ultra sound if you experience unusual bleeding or pain during your period. These tests not only detect ovarian cysts and identify the type, but also spot ovarian cancer in its early stages.

Treatment

The type of treatment depends on the type of cyst, its size and cancer risk, the age of the patient and the desire for future fertility.

For cysts which are likely to be functional, treatment is typically a course of oral contraceptives or a simple hormonal treatment. In some cases, surgical removal of the cyst (cystectomy) may be needed. For women with polycystic ovaries, treatment may take the form of med ication or sit rgery.